Resting functional connectivity between the hemispheres in childhood absence epilepsy
Resting functional connectivity between the hemispheres in childhood absence epilepsy
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DOI：
10.1212/wnl.0b013e31821e54de
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发表时间：
2011-06-01
期刊：
影响因子：
9.9
通讯作者：
Blumenfeld, H.
中科院分区：
文献类型：
--
作者：
Bai, X.;Guo, J.;Blumenfeld, H.
目的：儿童缺乏性癫痫（CAE）在癫痫发作之间改变神经网络的基本机制尚不清楚。在癫痫发作期间，皮层和皮层下网络表现出半球同步活动基于先前的脑电图-功能磁共振成像研究。我们的目的是利用血氧水平依赖（BOLD）静息功能连接方法，研究这种异常的双同步是否会延伸到间歇期。方法：记录16例CAE患者和16例年龄和性别匹配的对照组的EEG-fMRI数据。进行了三次分析。1)利用16对与癫痫相关的感兴趣区域（ROI），比较了患者与对照组间期静息功能连通性。2)对于CAE中显示半球间连通性显著增加的区域，我们随后计算了与整个大脑的连通性。3)在不受预定义roi约束的情况下，采用配对体素方法计算脑半球之间的静息功能连通性。结果：我们发现，与正常对照相比，CAE患者外侧眶额皮质半球间的静息功能连接显著增加。三种分析方法均证实了定位于外侧眶额皮质的半球间连通性增强。结论：我们的研究结果表明，CAE患者在癫痫相关区域的大脑半球之间的连接异常增加，即使在癫痫未发生时也是如此。这些发现提示眶额外侧皮层可能在CAE病理生理中起重要作用，值得进一步研究。此外，静息功能连通性分析可能提供一个有希望的生物标志物，以提高我们对CAE间期脑功能改变的理解。神经病学(R) 2011；76:1960 - 1967
Objective: The fundamental mechanisms by which childhood absence epilepsy (CAE) changes neural networks even between seizures remain poorly understood. During seizures, cortical and subcortical networks exhibit bihemspheric synchronous activity based on prior EEG-fMRI studies. Our aim was to investigate whether this abnormal bisynchrony may extend to the interictal period, using a blood oxygen level-dependent (BOLD) resting functional connectivity approach.Methods: EEG-fMRI data were recorded from 16 patients with CAE and 16 age-and gender-matched controls. Three analyses were performed. 1) Using 16 pairs of seizure-related regions of interest (ROI), we compared the between-hemisphere interictal resting functional connectivity of patients and controls. 2) For regions showing significantly increased interhemispheric connectivity in CAE, we then calculated connectivity to the entire brain. 3) A paired-voxel approach was performed to calculate resting functional connectivity between hemispheres without the constraint of predefined ROIs.Results: We found significantly increased resting functional connectivity between hemispheres in the lateral orbitofrontal cortex of patients with CAE compared to normal controls. Enhanced between-hemisphere connectivity localized to the lateral orbitofrontal cortex was confirmed by all 3 analysis methods.Conclusions: Our results demonstrate abnormal increased connectivity between the hemispheres in patients with CAE in seizure-related regions, even when seizures were not occurring. These findings suggest that the lateral orbitofrontal cortex may play an important role in CAE pathophysiology, warranting further investigation. In addition, resting functional connectivity analysis may provide a promising biomarker to improve our understanding of altered brain function in CAE during the interictal period. Neurology (R) 2011;76:1960-1967